Professional Documents
Culture Documents
On On separate form
Jemma Separate Severe headaches
Form
On On separate form
Benjamin Separate
Form
On On separate form
Kalli Separate Parents are separated
Form
On separate form Dual Citizen in
On Germany – attends
Dylan S. Separate school there in
Form summer and over
breaks
On On separate form
Completed speech last
Kono Separate
year
Form
On On separate form
Kaeley Separate
Form
On On separate form
Jacob Separate
Form
On On separate form
Dakota Separate
Form
* Possible Identifiers: 504 Plan - Legal in-class accommodations; FY – Foster Youth; GATE - Gifted & Talented Education; H – Homeless;
HR – High Risk; MED- Medical Condition; MI. Ed. - Migrant Education; Ret - Retained; RSP - Resource Specialist Program;
S/L - Speech & Language; SP - Special Education w/IEP; SST – Student Study Team interventions
Students with Previous SST Interventions (within the last two years):
SST Date to
First Name Interventions to Implement
Reconvene
Will meet after
Kayda parent SST last year. We will reassess at the end of this quarter.
conferences
Reduced homework, sitting in front of class, reading buddy for AR, testing by
Dylan F. 10/1 Speech specialist on site, receiving speech support from a licensed Speech
Pathologist.
I have two options available to me to meet the requirements to earn my clear credential:
Modified from the FACT Documents by Clovis Unified School District
Copyright Commission on Teacher Credentialing and the California Department of Education
Formative Assessment for California Teachers (FACT)—June, 2015
For Option #2 only: As a summer school site administrator I will help facilitate the participating teacher’s access to an
English learner. I verify that he/she has my permission to complete Option 2.
____________________________________________________ ____________________
(Summer School Administrator Signature) (Date)